8 diabetes myths you need to stop believing

From womensweekly.com.au

By Ashleigh Austen

From the impact of sugar to whether or not it’s genetic, an expert sets the record straight 

Diabetes is one of Australia’s most common chronic conditions, yet it remains widely misunderstood.

More often than not, ideas about who gets diabetes, how it develops and what living with it really involves are shaped more by outdated stereotypes than medical fact. That confusion matters: it can delay diagnosis, fuel stigma and make an already demanding condition harder to manage.

Here, we unpack eight of the most persistent myths about diabetes and explain what the evidence actually tells us.

Myth 1: Type 1 diabetes is caused by eating too much sugar

This is one of the most damaging myths of all. Type 1 diabetes (T1D) has nothing to do with diet or lifestyle. It is a chronic autoimmune condition that occurs when the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. Without insulin, the body cannot regulate blood glucose levels, making lifelong insulin therapy essential.

“In type 1 diabetes, the immune system mistakenly attacks the insulin-producing cells in the pancreas, resulting in the person losing the ability to produce their own insulin. Sugar or ‘junk food’ does not cause this autoimmune process,” explains endocrinologist Dr Ben Nash, who lives with type 1 diabetes.

No amount of sugar intake causes T1D. The condition develops silently over many years, often long before symptoms appear. Blaming food choices not only spreads misinformation but also places unnecessary guilt on people living with the condition.

                                          Eating too much sugar does not lead to being diagnosed with T1D. Image: Canva

Myth 2: Type 1 diabetes only affects children

While T1D is often diagnosed in childhood, it can develop at any age. Each year, around 3,000 Australians – many of them children – are diagnosed with T1D, which is the equivalent of eight people every day. However, adults are also diagnosed, sometimes well into later life.

“Approximately 50 per cent of people with type 1 diabetes are diagnosed in adulthood, yet many still think of it as a childhood condition,” says Dr Nash.

This misconception matters. “Adults with symptoms such as weight loss, thirst, fatigue, or frequent urination are often misdiagnosed with type 2 diabetes. Delayed diagnosis can lead to serious illness, including diabetic ketoacidosis, a diabetes emergency that can be life-threatening.”

Myth 3: Diabetes always runs in families

Family history does play a role, but it is far from the whole story. Approximately 90 per cent of people diagnosed with T1D have no known family history of the condition. That means most diagnoses come as a complete shock.

Dr Nash explains: “There is a genetic component, but 9 out of 10 people with type 1 diabetes have no family history.” While certain genes are associated with increased risk, “having these genes alone is not enough to cause someone to develop type 1 diabetes.”

Instead, “it is thought that an additional environmental trigger, in addition to genetic factors work together to cause type 1 diabetes to develop.”

Myth 4: You can ‘outgrow’ type 1 diabetes

Type 1 diabetes is lifelong. Because the body permanently loses its ability to produce insulin, there is currently no cure and no way to outgrow the condition.

“Once the immune system destroys insulin-producing cells, the body cannot regenerate them,” says Dr Nash. “That’s why people with T1D must give themselves insulin every day.”

Management requires daily insulin, careful monitoring of blood glucose levels and constant decision-making, a reality that is often underestimated by those who don’t live with the condition.

Myth 5: Insulin means you’ve failed to manage diabetes properly

This myth is particularly misleading when it comes to T1D. People with type 1 diabetes need insulin to survive, full stop.

“Insulin is essential for people living with type 1 diabetes because their bodies are no longer able to produce it,” says Dr Nash. “In type 1 diabetes, insulin is simply replacing a hormone the body no longer makes.”

Without insulin, blood glucose levels rise dangerously and can quickly lead to diabetic ketoacidosis (DKA), a life-threatening complication and a leading cause of hospitalisation for people with T1D.

                                     With the correct treatment plan, those with diabetes can lead healthy lives. Image: Canva

Myth 6: People with diabetes can’t live full, active lives

Living with diabetes is demanding, but with appropriate treatment and support, people with T1D can and do live full, active lives.

“Living well with type 1 diabetes means people can pursue careers, travel, exercise, and spend time with family without limits,” says Dr Nash. “Advances in diabetes technology has made this more possible than ever.”

However, he notes that much of the effort involved goes unseen. “The invisible work includes constant monitoring, planning ahead, carrying supplies and making decisions that most people never think about.”

Myth 7: The symptoms are always obvious

Classic symptoms such as excessive thirst, frequent urination and unexplained weight loss are well known, but they don’t always appear suddenly or clearly.

“These symptoms can develop gradually and be mistaken for stress, viral illness, menopause, or other conditions,” says Dr Nash.

If insulin is not started in time, high blood glucose levels can escalate rapidly into DKA. “Delayed diagnosis can lead to serious illness, such as diabetic ketoacidosis, a medical emergency that results from inadequate insulin levels to meet the needs of the person with diabetes.”

Myth 8: Diabetes isn’t that expensive to manage

The financial burden of type 1 diabetes in Australia is substantial and increasing. Ongoing costs include insulin, glucose monitoring supplies, medical appointments and, for many families, lost income due to reduced work capacity. These costs are lifelong, reflecting the permanent nature of the condition.

https://www.womensweekly.com.au/health/diabetes-myths/

The invisible mental load of type 1 diabetes

From bodyandsoul.com.au

It takes a toll 

While you may be familiar with the insulin pumps and blood tests that become part and parcel with a type 1 diabetes diagnosis, you're probably less aware of the mental burden of the disease. 

Know someone with type 1 diabetes? Those affected make hundreds of health decisions every day, balancing insulin, food, movement and rest in a way that many of us are unaware of.

And while type 2 diabetes is far more common, due to its link to lifestyle factors, type 1 is a different beast: an autoimmune disease, with an unknown cause, and no cure. 

It's no wonder burnout, anxiety and poor sleep are so common in people with type 1 diabetes. Yet these side effects are rarely spoken of, surpassed by the physical demands of the condition. 

Often thought of as a childhood condition, around 88 per cent of people living with type 1 diabetes in Australia are 21 or older, managing their condition while juggling work, family, social lives and more.

Beyond the long-term damage and complications caused by diabetes (including permanent damage to eyesight), the toll of managing the condition can increase the likelihood of mental health issues. 

With over 1.3 billion people predicted to have diabetes by 2050, these cumulative side effects are worth considering, whether you or someone you love is affected.

Hundreds of decisions, every day

Dr Ben Nash, a Melbourne-based endocrinologist and medical affairs director at Medtronic Diabetes Australia, was 17 when he was diagnosed with type 1 diabetes. 

“There's a lot of cognitive burden, a lot of micro decisions that you have to make with type 1 diabetes, every day and every minute of every day,” said Nash at a recent Medtronic event. “It's essentially like having a second job – unfortunately, it's not a job you've asked for.”

Image: iStock

Describing type 1 diabetes management as “like walking a tightrope,” Nash says it requires a constant balance between blood sugar that’s too high, with long and short-term risks, and blood sugar that’s too low, which can starve the brain of glucose.

That constant balancing act carries a significant psychological cost, says psychotherapist and counsellor Rebecca Hirst. “There is a constant need for risk management, and personal responsibility for survival – a kind of vigilance that means one can never really switch off, with a nervous system on a low-level ‘threat response’ mode,” says Hirst.

Phoenix Goozée was diagnosed with type 1 diabetes when he was six, and for him, keeping well has become a second nature. Staying active and healthy has helped his situation a lot, says Phoenix., who adds that “If you stick to the practices of a healthy life, that coincides with a healthy diabetic."

“People managing chronic health conditions, especially in adulthood, have often developed very high levels of competence – adaptive coping strategies that signal ‘Everything’s fine’, when in fact, the weight of living with the condition may be becoming unmanageable,” says Hirst.

The mental load of diabetes can also fall to family members. Image: iStock

While Goozée says he doesn’t feel mentally burdened by diabetes, he admits that life would, of course, be easier without it. “It has become second nature, the injections and checking sugar levels, but I wish I didn’t have to do that,” he says. “I see people eating, not thinking about what their sugar levels are…it’s a bit of a pain in the arse, to be honest.”

The mental load can also fall to family members. “My partner Emily is really good at picking up the cues of me having a hypo [when blood glucose drops too low],” says Goozée. “We’ve had ambulances called because of a few close calls, so she’s had the mental load on that side of things.”

Supporting a loved one with type 1 diabetes

While often we focus on the medical side of chronic illness, family and friends should also be aware of a person’s felt experience, says Hirst. “We know that when someone feels alone or emotionally misunderstood in their experience, their stress and pain levels increase, and their symptoms often do too,” she says.

To better support a loved one with type 1 diabetes, acknowledge the invisible load they’re carrying, but also avoid ‘checking behaviours’, as this can undermine a person’s autonomy. Image: iStock

To better support a loved one with type 1 diabetes, acknowledge the invisible load they’re carrying, but also avoid ‘checking behaviours’, as this can undermine a person’s autonomy.

It's also crucial to do your own research. “You can help reduce the cognitive load of your loved one by learning about the condition independently, and even helping to educate others for them,” says Hirst.

While some people with type 1 diabetes, like Goozée, reduce the load through strict routines, others rely on technology to help shoulder the cognitive work. Advances such as continuous glucose monitoring and insulin pump systems are designed to respond to changes in glucose levels in real-time, reducing the need for decision-making. 

There’s no ‘threshold’ of suffering that people need to reach in order to be justified in choosing to start therapy. Image: iStock

Since his diagnosis as a teen, Nash has gone on to specialise in diabetes, yet he admits he still has “a hard time with diabetes on a day-to-day basis.”

“It's not easy – it takes a whole team to help manage it,” says Nash. “There's this constant background burden you have to deal with on top of all the other important things you have to do day-to-day.”

From a mental health perspective, Hirst says there doesn’t need to be a breaking point to seek support.

“There’s no ‘threshold’ of suffering that people need to reach in order to be justified in choosing to start therapy,” she says.

https://www.bodyandsoul.com.au/health/mental-health/the-invisible-mental-load-of-type-1-diabetes/news-story/529cf0fd0793e0556f6545e48879b302

The Best Morning Drink for Better Blood Sugar, According to Dietitians

From eatingwell.com

The right morning drink can help prevent blood sugar spikes and crashes. Here’s why registered dietitians recommend a well-balanced smoothie 

KEY POINTS

• Some drinks have lots of added sugar. A balanced smoothie might help blood sugar. 
• Adding fibre, protein and healthy fats is key to making a smoothie that’s good for blood sugar. 
• Try water, unsweetened coffee, green tea or herbal tea for other blood sugar–friendly drinks.

Eating a balanced breakfast each morning can have a big impact on your blood sugar levels, and what you sip on is important, too. Many people don’t realize that their favourite flavoured coffee drinks and juices are loaded with added sugars that can cause blood sugar to spike. But more intentional drink choices—such as a well-balanced smoothie that has protein, healthy fats and fibre—can be a much better option in terms of impacting your blood sugar.

When made with the right mix of fibre-rich fruits and vegetables, protein and healthy fats, a smoothie digests more slowly than many sugary drinks, helps minimize post-meal blood sugar spikes, and supports steadier energy through the morning. 

Here’s why registered dietitians recommend starting your day with a nutritious smoothie for better blood sugar, and why blending in protein, fibre-rich fruits and vegetables, and healthy fats is so important.  

Why a Well-Balanced Smoothie Is the Best Morning Option for Better Blood Sugar

It’s Hydrating

After not eating or drinking for eight hours or so while sleeping, many people wake up slightly dehydrated. When you’re dehydrated, your blood volume drops, which can make blood sugar concentrations appear higher, says Lindsay Cohen, RDN.

“A smoothie provides a significant amount of fluid, especially when water or unsweetened nut milk is used as a base, helping to prevent dehydration,” Cohen says.

Hydrating doesn’t directly lower blood sugar, says Serena Pratt, M.S., RDN. But it can help indirectly by supporting consistent routines, appetite and focus, all of which can influence food choices and other lifestyle habits that play a role in blood sugar management.

It’s High in Fibre, Which Helps Stabilise Blood Sugar

Fruits like blueberries, strawberries and blackberries add a sweet flavour to your smoothies along with fibre, which supports satiety and blood sugar control, says Kimberly Gomer, M.S., RD. Similarly, veggies like spinach, kale and riced cauliflower add fibre without much sugar.

Fibre supports digestion and slows stomach emptying, which helps slow the absorption of sugar into the bloodstream, contributing to a more gradual rise in blood sugar. When you have a sugary drink without fibre, like soda or juice with lots of added sugars, there can be a larger spike in blood sugar.

Adding Healthy Fats Can Leave You Feeling Full and Satisfied

Chewing your food helps signal feelings of fullness and satisfaction, so you’re not immediately thinking about eating something else. But when you drink a smoothie, there isn’t much chewing involved. “As a result, a smoothie can go down quickly, and it may not register as being as satisfying as a meal eaten with a utensil,” Pratt says. 

This doesn’t mean a smoothie isn’t a good idea; you just need to make sure it contains the right ingredients. Blending in some healthy fats can help, since they take a while to break down and digest, leaving you more satisfied. “Adding healthy fats, like nut butter, chia or flax seeds, avocado or full-fat Greek yogurt, helps slow down stomach motility, increasing satiety and supporting a steadier rise in blood sugar,” Pratt says.

Adding Protein Helps Minimise Blood Sugar Spikes

Having some protein in the morning gives you energy for the day, while also increasing satiety and helping keep blood sugar levels stable. 

“Protein is digested more slowly than carbohydrates, and when consumed with carbohydrates, can help slow how quickly the blood glucose rises,” Cohen says. “Protein also stimulates the release of hormones that slow down gastric emptying and can actually improve your body’s insulin response.”

Greek yogurt, soy milk, dairy milk and protein powder are all good options if you’re looking to add some protein to your morning smoothie.

Other Drink Options to Consider:

• Water: Water contains no sugar or carbohydrates and is one of the best ways to stay hydrated. “When you are dehydrated, your blood volume decreases, which makes the glucose in your bloodstream more concentrated,” Cohen says. “Drinking water helps the kidneys flush out excess sugar through urine and helps maintain a healthy blood volume.”
• Unsweetened green tea: Green tea is packed with antioxidants that may improve insulin sensitivity and lower blood sugar levels, research shows. “Over time, regular consumption of green tea has been associated with lower fasting glucose levels and improved long-term glycaemic control,” Cohen says. 
• Unsweetened coffee: Drinking unsweetened coffee may be associated with a lower risk of type 2 diabetes. Interestingly, the association isn’t as strong when people add sugar or artificial sweeteners to their coffee, researchers found. “Some people might find that coffee on an empty stomach can increase anxiety or GI symptoms, so pairing it with a balanced breakfast can help,” Pratt says.
• Protein coffee: “Combining coffee, milk and a scoop of protein powder combines caffeine and protein while avoiding sugary syrups or powders,” Pratt says. This can be a more blood sugar–friendly swap for a sugary latte. 
• Herbal tea: “Herbal teas are naturally caffeine-free, so they provide hydration without the potential cortisol rise that can occasionally cause temporary blood glucose fluctuations in sensitive individuals,” Cohen says.

• Our Expert Take

  If you’re looking for a morning drink that supports your blood sugar levels, consider a balanced smoothie made with fibre-rich fruits and vegetables, protein and healthy fats. Aside from being rich in nutrients, this type of smoothie can slow digestion, keep you satisfied and help you avoid the sharp blood sugar spikes you might experience after having a drink with lots of added sugars.

• 
  

• https://www.eatingwell.com/best-morning-drink-for-better-blood-sugar-11889073
  

Medical Compass: Protecting your vision when you have diabetes

From tbrnewsmedia.com

By David Dunaief, M.D.

A serious complication of diabetes is diabetic retinopathy (DR), which is the leading cause of blindness among U.S. adults. DR develops when high blood sugar damages the tiny blood vessels that supply the retina—the light-sensitive tissue at the back of the eye. Over time, this damage can lead to blurred vision and even permanent blindness, often in both eyes.

Despite the risks, many people with diabetes are not getting regular eye care. As of 2023, only about 66 percent of adults with diabetes received the recommended annual eye exam. This is concerning because early detection makes a huge difference. When DR is caught early, treatments are far more likely to prevent or limit lasting vision loss.

                                                                                                                                   METRO photo

A common complication: diabetic macular edema

A serious consequence of diabetic retinopathy is diabetic macular edema (DME). With DME, fluid builds up in the macula, the central part of the retina responsible for sharp, detailed vision. Swelling in this area can significantly impair eyesight, making everyday activities like reading or driving difficult.

People who have had diabetes for many years face the highest risk for DME. Unfortunately, symptoms often do not appear until the condition is advanced. By then, some of the damage may already be irreversible.

How is diabetic macular edema treated?

Treatments for DME often include eye injections of anti-VEGF medications, sometimes combined with laser therapy. These medications block vascular endothelial growth factor (VEGF), a protein that contributes to abnormal blood vessel growth and leakage in the eye. This can slow disease progression and, in some cases, improve vision.

A randomized controlled trial found that injections of ranibizumab (Lucentis), used alongside laser treatment—whether the laser was given immediately or delayed—were effective in treating DME. Other treatment options may include anti-inflammatory eye drops, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or steroids, which aim to reduce swelling in the macula.

Do diabetes medications reduce the risk of DME?

Surprisingly, medications used to treat type 2 diabetes do not necessarily reduce DME risk. In fact, some may increase it. The THIN trial, a large retrospective study, found that a class of diabetes drugs called thiazolidinediones—which includes Avandia and Actos—was linked to a higher incidence of DME compared to patients who did not use these medications.

After one year, 1.3 percent of patients taking these drugs developed DME, compared with just 0.2 percent of those who were not taking them. This increased risk continued throughout 10 years of follow-up. The FDA has also issued warnings about other serious side effects associated with this drug class.

The risk appeared even higher in patients who used both thiazolidinediones and insulin. However, researchers could not determine whether the increased risk was caused by the medications themselves or by more severe diabetes.

Not all studies agree. An ACCORD Eye sub-study did not find a link between thiazolidinediones and DME. That study examined retinal photographs from almost 3,000 participants. Both studies had limitations, including incomplete data on how long patients had taken the medications and how well their blood sugar was controlled. Researchers also noted that not all potential influencing factors could be accounted for.

Can diet and blood sugar control help protect vision?

Better blood sugar control does appear to reduce the risk of diabetic retinopathy. The main ACCORD trial showed that intensive glucose control using medications lowered the risk of DR progression. However, this approach also increased overall mortality and did not reduce major cardiovascular events.

These results suggest an important takeaway: how blood sugar is controlled matters. A nutrient-dense, plant-based diet that helps maintain healthy blood sugar levels may lower your risk of diabetic retinopathy and further vision loss—without the added risks seen with medication-intensive approaches.

Protecting your vision

If you have diabetes, the most effective way to protect your eyesight is to keep your blood sugar well controlled and to schedule yearly eye exams with an ophthalmologist. Regular screenings can identify problems early, when treatment is most effective and vision loss may still be preventable. This is especially important for people taking thiazolidinediones or those who have had diabetes for many years.

Because your eyes are often affected long before you notice symptoms, it’s important to stay proactive. It can make the difference between preserving your vision and losing it.

https://tbrnewsmedia.com/medical-compass-protecting-your-vision-when-you-have-diabetes/ 

Guarding Your Independence With Type 2 Diabetes: 7 Risks and Solutions

From everydayhealth.com

Type 2 diabetes doesn’t necessarily lead to a loss of independence on its own. But diabetes complications such as vision loss, muscle weakness, and cognitive decline can make it harder to maintain your quality of life on your own.

Mitigating and avoiding these risks starts with blood sugar control and weight management, but good diabetes management can go a step further. Other solutions can include exercising, sleeping right, and even staying socially active.

1. Risk: Vision Loss

Eyesight can be an essential part of maintaining your quality of life. But poorly managed blood sugar increases your risk of diabetic retinopathy, damage to the blood vessels in your eye’s retina that can lead to vision loss and blindness.

When insulin isn’t working effectively, too much sugar stays in your bloodstream. Over time, this can damage blood vessels throughout the body, says Charles Barron Jr., MD, chief medical officer of Friend Health, a provider for medically underserved communities in Chicago. 

“The eyes have very small blood vessels, and when we can't get blood flow to them, cellular death starts to occur,” Dr. Barron says.

More than 9.5 million people in the United States have diabetic retinopathy, including 26 percent of people with diabetes. It threatens the vision of 1.84 million of those people, about 5 percent of people with diabetes.

About 1 in 14 people with diabetes also develop diabetes-related macular edema, swelling in the macula (the central part of your retina) that can lead to blindness. It is the leading cause of vision loss among people with diabetes, says Jennifer Cheng, MD, chief of endocrinology at Hackensack Meridian Health in Neptune, New Jersey. 

Solution: Get Your Blood Sugar and Blood Pressure Under Control

Managing your blood sugar effectively is key for reducing your risk of diabetes complications, and vision loss is no exception. If you have hypertension, or high blood pressure, lowering your blood pressure could slow the progression of vision issues. Eating healthy foods, exercising regularly, losing excess weight, and taking prescribed medication can help. Injections or lasers can also treat macular edema.

2. Risk: Muscle Weakness (Sarcopenia)

Age-related loss of muscle mass and function, or sarcopenia, affects more than half of people age 80 and older. It can lead to depression, falls, and bone fractures, all of which can reduce your ability to get around on your own.

Type 2 diabetes can speed up this process, which makes it harder for you to control your blood sugar and to be physically active — leading to additional diabetes complications.

In fact, more than 22 percent of people age 50 and older with type 2 diabetes have sarcopenia, compared with 8.8 percent of people who do not have type 2 diabetes. Dr. Cheng says that the following factors contribute to this increased risk of muscle breakdown:

• Insulin resistance
• Chronic inflammation
• Increased accumulation of harmful substances in muscle fibres caused by high blood sugar 

Your risk may be greater if you have the following conditions:

• High blood pressure
• Low calcium levels
• Nerve damage
• Low amount of physical activity

Solution: Strength-Building Exercise

Regardless of your age, building strength can help maintain muscle mass and manage type 2 diabetes. Two or three resistance-training sessions each week can improve blood sugar control and help your body use insulin efficiently. You don’t even need to go to the gym and use heavy equipment to get results. Barron recommends using a can of food as a dumbbell and performing flexing exercises (think curls or overhead presses) to maintain strength. 

3. Risk: Foot Problems

People with type 2 diabetes have an increased risk of foot issues, from poor circulation to rare and serious conditions such as Charcot foot, that make it difficult or impossible to walk. About 15 percent of people with diabetes get diabetic foot ulcers, usually on the bottom of the foot. Although often preventable, they can lead to amputation in 14 to 24 percent of cases.

Foot issues can be the result of nerve damage or peripheral artery disease, which can reduce blood flow in your feet and can make it harder for foot sores to heal.

“The toes have very small blood vessels, and when circulation is compromised, these areas are particularly vulnerable,” says Barron, adding that doctors typically check your toes and feet for sensation changes and look for evidence of decreased blood flow.

Solution: Daily Foot Care

Wear shoes or socks around the house, and avoid going barefoot or exposing your feet to extreme temperatures, Barron says. Check your feet every day to prevent small problems from becoming large ones. If you develop a foot sore or ulcer, preventing infection by keeping it clean, bandaged, and medicated (when prescribed) is your best bet to avoid complications. Your doctor may refer you to a podiatrist or wound-care specialist for additional treatment.

4. Risk: Severe Hypoglycaemia

Medications that treat type 2 diabetes can lower blood sugar levels, but they can also cause levels to drop too low, known as hypoglycemia. These medications include sulfonylureas and insulin.

Symptoms include hunger, shakiness, and confusion. Though mild cases of hypoglycaemia can be treated with a sugary snack or drink, severe cases of hypoglycaemia cause a risk of losing consciousness, Barron says.

If you are at least 70 years old and have type 2 diabetes, you have an increased risk of being hospitalized for severe hypoglycaemia while taking insulin or sulfonylureas. The risk increases with age.

Solution: More Blood Sugar Testing

Testing blood sugar more frequently helps you make better decisions about medication. Barron says that doctors may monitor your blood sugar levels remotely to gauge blood sugar control more accurately. Continuous glucose monitors give you real-time updates and alarms so you can learn quickly if you have hypoglycaemia.

5. Risk: Chronic Fatigue

“Chronic fatigue is a prevalent and often overlooked symptom in type 2 diabetes, significantly eroding quality of life,” Cheng says. 

This is because high blood sugar from untreated type 2 diabetes affects your ability to convert sugar into energy. The build-up of sugar also causes your kidneys to work harder, leading to frequent urination that can interrupt your sleep.

Being overweight or having obesity can contribute to fatigue, as your body may have to work harder to perform everyday tasks.

Sleep comes into play, as well. People with type 2 diabetes often sleep poorly and wake frequently during the night, Barron says. These sleep issues, including obstructive sleep apnoea and insomnia, can contribute to fatigue.

Solution: Good Sleep Hygiene

Prioritize habits that lead to better sleep:

• Don't use electronic devices before bed.
• Exercise during the day.
• Keep blood sugar and blood pressure levels consistent.
• Limit daytime naps of more than 30 minutes.
• Create a comfortable sleep environment, free of light and noise.

In addition, talk to your doctor about getting tested and potentially treated for sleep apnea, a condition in which your airway is completely or partially obstructed during sleep. About 7 in 10 people with type 2 diabetes have obstructive sleep apnoea, which your healthcare team can help you treat.

6. Risk: Cognitive Decline

Losing mental function, such as memory, language, reasoning, and judgment, can limit your ability to do things on your own. Cognitive impairment increases as you age, and it is more common in people with type 2 diabetes, especially those age 65 and older. Risk factors may include obesity, chronic inflammation, and cardiovascular complications of diabetes.

Informally, the progressive brain disorder Alzheimer’s disease is sometimes called type 3 diabetes. The long-term blood sugar problems linked to diabetes may increase the risk of Alzheimer’s and speed memory loss by interfering with how brain cells function.

“Insulin resistance can impair brain cell function and communication,” Cheng says. “If there is not enough sugar in the brain, then there could be damage, especially with severe hypoglycaemia.”

Solution: Brain Stimulation

Maintaining stable blood sugar and staying mentally active can support brain health and functional independence, Barron says. Stimulating activities for your brain include playing cards or board games, learning a new language, trying a new recipe, visiting a new vacation spot, and even planning a dinner party. Trying new things can help your brain form new connections.

7. Risk: Social Isolation

Loneliness can affect quality of life and independence in many ways: Not only can it increase the risk of cognitive decline and conditions such as type 2 diabetes but it also affects mental health — with lonely people being twice as likely to get depressed.

People with type 2 diabetes are especially vulnerable to loneliness and social isolation, with nearly 20 percent of people with the condition also experiencing intense loneliness.

“From a social perspective, people may decline to go out because they feel like they're not going to be able to eat freely, they're embarrassed because they may have to check blood sugar, or [they experience] different social aspects that can impact whether they want to spend time with others,” Barron says. 

People who feel isolated or lonely are more likely to develop diabetes-related problems such as kidney disease, nerve damage, and eye damage than those who are more socially connected. In fact, the risk is about as strong as those associated with smoking, high blood pressure, and low physical activity.

Solution: Explore and Expand Your Community

To get a sense of belonging, take a class to learn something new with others, schedule time each day to stay in touch with family or friends, consider adopting a pet if you can care for one, introduce yourself to your neighbours, or join a community cause to get involved. It's also important to educate your family members and friends about type 2 diabetes so they can help you navigate certain situations, without putting pressure on you to do something you can’t because of the disease, Barron says. 

The Takeaway

• Effective management of type 2 diabetes, including control of your blood sugar level and weight, can substantially reduce the risk of complications that threaten your independence.
• If you do not control your blood sugar well, you may risk changes to your vision, muscle mass, and cognitive abilities, as well as foot problems, hypoglycaemia, and fatigue.
• In addition to good blood sugar control and metabolic health, solutions such as ensuring that your blood pressure is under control, exercising, and even staying socially active can help mitigate risks of complications.
• Talk to your healthcare team about the best ways to manage your type 2 diabetes and what change you can make to maintain and improve your quality of life.

https://www.everydayhealth.com/diabetes/guarding-your-independence-with-type-2-diabetes/